Roy W. Sanders, M.D.

Posttraumatic malunion of the tibia is not an uncommon problem, particularly when the fracture was originally treated with a cast or external fixation device. The malunion may cause significant problems with gait, and many patients complain of pain in the knee and ankle joints. While several different procedures are available for tibial corrections, Dr. Roy Sanders has applied the oblique osteotomy, first popularized by Dr. Jeffrey Mast, to his problem cases with excellent results.

Dr. Sanders has adopted the oblique osteotomy because, in his opinion, it gives the surgeon the advantage of deformity correction in all four planes with a single cut. It also allows for up to 2 1/2 cm of lengthening. In this VJO presentation, the patient presented with a 15-degree valgus deformity with approximately 15 mm of shortening due to the tibial malunion.

The success of this procedure comes from combining extensive preoperative planning, the oblique osteotomy, and stabilization with a lag screw and neutralization plate. In the last 24 cases performed by Dr. Sanders, the patients have had healing within three months and no nonunions, plate breakages, or failures.

References
1. Mast J, Teitge R, Gowda M Preoperative Planning for the Treatment of Nonunions and the Correction of Malunions of the Long Bones Orthop Clin N Am 1990-;21:693

   Sanders R, Anglen J, Mark J The oblique osteotomy for correction of tibial malunions J Bone and Joint Surg 1994;76A, in press

   Brooker AF Interlocking tibial nailing: Osteotomy and reduction of a chronic distal third non-union Video J Ortho 1988;3(20

   Wiss DA Interlocking Nailing of the Fractured Tibia: Advances in Technique Video J Ortho 1987;2(4)

• Total Run Time: 15:49 minutes
• Catalog Number: 6013
• Publication Date: August 1994

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